From Current Opinion in Infectious Diseases.
New and noteworthy:
If appropriate antibiotics are given within the first hour of hypotension the survival rate in one study was 79.9% and declined by 7.6% per hour of delay.
While elevated lactate levels may result from acceleration of glycolysis due to hypermetabolism rather than tissue hypoxia, levels of 4 meq/l or above are concerning and indicate need for aggressive hemodynamic support.
New data from the CORTICUS study were cited regarding the use of corticosteroids in patients with shock. No benefit was found. Corticosteroids can be considered in selected cases, but routine use is no longer warranted.
EGTD, activated protein C and other bundle components are discussed